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Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients.
Sex Transm Dis. 2014 Mar; 41(3):168-72.ST

Abstract

BACKGROUND

In 2010, the Centers for Disease and Control and Prevention recommended using nucleic acid amplification tests (NAATs) for extragenital gonorrhea (GC) and chlamydia (CT) testing because of NAATs' improved sensitivity compared with culture.

METHODS

In 2011, the Public Health-Seattle & King County Sexually Transmitted Disease Clinic introduced NAAT-based testing for extragenital GC and CT infection in men who have sex with men (MSM) using AptimaCombo2. We compared extragenital GC and CT test positivity and infection detection yields in the last year of culture-based testing (2010) to the first year of NAAT testing (2011).

RESULTS

Test positivity of GC increased by 8% for rectal infections (9.0%-9.7%) and 12% for pharyngeal infections (5.8%-6.5%) from 2010 to 2011; CT test positivity increased 61% for rectal infections (7.4%-11.9%). Pharyngeal CT was identified in 2.3% of tested persons in 2011 (not tested in 2010). We calculated the ratio of extragenital cases per 100 urethral infections to adjust for a possible decline in GC/CT incidence in 2011; the GC rectal and pharyngeal ratios increased 77% and 66%, respectively, and the CT rectal ratio increased 127%. The proportion of infected persons with isolated extragenital infections (i.e., extragenital infections without urethral infection) increased from 43% in 2010 to 57% in 2011.

CONCLUSIONS

Extragenital testing with NAAT substantially increases the number of infected MSM identified with GC or CT infection and should continue to be promoted.

Authors+Show Affiliations

From the *Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA; †Public Health-Seattle & King County HIV/STD Program, Seattle, WA; and ‡Department of Epidemiology, University of Washington, Seattle, WA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

24521722

Citation

Barbee, Lindley A., et al. "Effect of Nucleic Acid Amplification Testing On Detection of Extragenital Gonorrhea and Chlamydial Infections in Men Who Have Sex With Men Sexually Transmitted Disease Clinic Patients." Sexually Transmitted Diseases, vol. 41, no. 3, 2014, pp. 168-72.
Barbee LA, Dombrowski JC, Kerani R, et al. Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients. Sex Transm Dis. 2014;41(3):168-72.
Barbee, L. A., Dombrowski, J. C., Kerani, R., & Golden, M. R. (2014). Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients. Sexually Transmitted Diseases, 41(3), 168-72. https://doi.org/10.1097/OLQ.0000000000000093
Barbee LA, et al. Effect of Nucleic Acid Amplification Testing On Detection of Extragenital Gonorrhea and Chlamydial Infections in Men Who Have Sex With Men Sexually Transmitted Disease Clinic Patients. Sex Transm Dis. 2014;41(3):168-72. PubMed PMID: 24521722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients. AU - Barbee,Lindley A, AU - Dombrowski,Julia C, AU - Kerani,Roxanne, AU - Golden,Matthew R, PY - 2014/2/14/entrez PY - 2014/2/14/pubmed PY - 2014/11/5/medline SP - 168 EP - 72 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 41 IS - 3 N2 - BACKGROUND: In 2010, the Centers for Disease and Control and Prevention recommended using nucleic acid amplification tests (NAATs) for extragenital gonorrhea (GC) and chlamydia (CT) testing because of NAATs' improved sensitivity compared with culture. METHODS: In 2011, the Public Health-Seattle & King County Sexually Transmitted Disease Clinic introduced NAAT-based testing for extragenital GC and CT infection in men who have sex with men (MSM) using AptimaCombo2. We compared extragenital GC and CT test positivity and infection detection yields in the last year of culture-based testing (2010) to the first year of NAAT testing (2011). RESULTS: Test positivity of GC increased by 8% for rectal infections (9.0%-9.7%) and 12% for pharyngeal infections (5.8%-6.5%) from 2010 to 2011; CT test positivity increased 61% for rectal infections (7.4%-11.9%). Pharyngeal CT was identified in 2.3% of tested persons in 2011 (not tested in 2010). We calculated the ratio of extragenital cases per 100 urethral infections to adjust for a possible decline in GC/CT incidence in 2011; the GC rectal and pharyngeal ratios increased 77% and 66%, respectively, and the CT rectal ratio increased 127%. The proportion of infected persons with isolated extragenital infections (i.e., extragenital infections without urethral infection) increased from 43% in 2010 to 57% in 2011. CONCLUSIONS: Extragenital testing with NAAT substantially increases the number of infected MSM identified with GC or CT infection and should continue to be promoted. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/24521722/Effect_of_nucleic_acid_amplification_testing_on_detection_of_extragenital_gonorrhea_and_chlamydial_infections_in_men_who_have_sex_with_men_sexually_transmitted_disease_clinic_patients_ L2 - http://dx.doi.org/10.1097/OLQ.0000000000000093 DB - PRIME DP - Unbound Medicine ER -